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[macula_densa]

As of a week ago, Nicole has lost her boyfriend, Bill, to leukemia. As of 2 and a half years before, he had become the love of her life. He was 39 years old

Comments

[sonya_08]

wow, how terrible!
Hope its just ehrlichia or fungal thing or something. But it seems like it never is.

[macula_densa]

I've seen a lot of Ehrlichia, and yes it definitely causes big lymph nodes, but I've never seen them quite like this. I don't think I've ever seen a tennis ball sized lymph node that wasn't cancer. If you or other vets want to pipe up and reassure me I would love that, because it's not like I'm in practice every day. But this looked really, really bad.

[sonya_08]

No, I have never seen lymph node that big not be cancer.
But every time I find myself hoping that its something else, but it never is.

[lissalee]

Ah I'm sorry. I agree with sonya, it's unfortunately usually lymphoma until proven otherwise, especially with other PLN that are enlarged. The minor positive is that if it popped up quickly, will likely respond well to an onco protocol for a while...

Maybe the other mass is an ulcerated histiocytoma? They can look just like mast cells!

Sorry for all your friend has gone through. Treating pets of friends and family is really hard. :(

[macula_densa]

Well, the dog is probably 9-10 years old. I don't generally see histiocytomas in dogs that age; do you?

I looked at the slide last night. It was a mixed inflammatory population, but there were a number of mast cells and eos present, so I think MCT is the likely culprit. I called her and told her to get that thing lopped off ASAP, possibly accompanied by the enlarged LN.

[lissalee]

They are certainly much more common in younger dogs, but I have seen them in all ages, and usually the path report will say that as well. However, it is usually a very monomorphic round cell population. I always confirm them and send them out to a pathologist, but have looked at lots in clinic before sending (or stain a slide for me-I'm such a nerd), and rarely have mast cells or eosinophils as part of the population. You get get a bunch of lymphocytes and inflammatory cells if they are undergoing regression.

[macula_densa]

Yeah, this was kind of a weird conglomeration of mast cells, eos, and plasma cells with a few neutrophils thrown in here and there. But actually, after looking further at pictures I'm not even convinced any more that they were plasma cells; I think they might be degranulated mast cells because there were a bunch of random granules surrounding them.

She took her to her own vet today and shared my impression with him. He's just going to take the damn thing off with wide margins on Friday.

[msubugvet]

FWIW, I've seen dogs with LSA (course it depends on what kind) do well for a couple years after diagnosis/treatment.

[macula_densa]

Yeah... I've seen them go both ways. I have a good friend whose dog's LSA was fairly refractory to the chemo, although he did get a few more good months out of it.